According to a 1999 Institute of Medicine Report, human error contributes to approximately 70,000-100,000 deaths per year caused by “medical errors.” As a designation, medical errors are associated with a multitude of circumstances and causes. However, studies show that a significant percentage of serious errors are associated with the administration of intravenous (IV) medication.
A patient's response to drugs delivered intravenously is rapid because the gastrointestinal system is bypassed. Thus, if an error is made, there is little time to compensate. Most critical drugs are delivered intravenously. Correct administration is a process that often involves several individuals for delivering an accurate dose of a drug to a particular patient at a prescribed time and through a particular administration route. It is not difficult to comprehend the potential for error, as well as the undesirable probability that the occurrence of an error can result in one or more detrimental effects to the patient.
An intravenous error may be induced at any time throughout the process of ordering, transcribing, dispensing, and administering a drug. For example, an ordering error may occur because an order is illegible, incomplete, or entered on the wrong patient's chart, because a decimal is misplaced or inappropriate, or unacceptable prescription abbreviations are used, or because an inappropriate drug is selected or a patient's allergies are not properly identified. Transcription errors may occur because an order was not transcribed, not completely signed off, or incorrectly transcribed onto the Medication Administration Record (MAR). Also, on occasion a patient's allergies are not transcribed or a transcription is illegible. Dispensing errors may occur with respect to the dose, or the identification of the medication or patient. An administration error may occur at any time during the course of a patient's care and may concern the patient or drug identification, or the time, dose, or route of drug administration. It is notable that research indicates that 60-80% of intravenous errors are attributed to humans. It follows then that one way to reduce the potential for error is to automate as much as possible the process of drug ordering, transcribing, dispensing, and administering.
Information technology may be utilized for automating portions of the drug ordering, transcribing, dispensing, and administration process. For example, the potential for error may be reduced by cross referencing infusion data used to program a pump and also by reviewing data programmed into a pump prior to enabling the pump to operate and also by detecting if programmed data is changed.
One system for collecting data and managing patient care is disclosed in U.S. Pat. No. 5,781,442 issued to Engleson et al. The system may include a pharmacy computer, a nursing station computer, and bedside computers that may be connected to clinical devices such as infusion pumps. The various computers are connected together via a local area network. The computers have memory for storing certain information relating to a patient's care and information can be inputted into the computers. The pharmacy computer will compare information communicated from the bedside computer to information stored in the pharmacy computer. If the comparison satisfies a predetermined condition, the pharmacy computer downloads clinical device operating parameters to the bedside computer. The bedside computer, in turn, programs the clinical device to operate in accordance with the downloaded operating parameters. The comparison of data is only performed by the pharmacy computer. This system requires several computers as a computer is required at each bedside in order to program the clinical device.
Another system for automatically entering into an infusion pump patient identification and drug data is disclosed in U.S. Pat. No. 5,317,506 (Coutrė et al.), entitled “Infusion Fluid Management System.” The '506 patent is directed at a pharmacy management system and an infusion pumping system in combination for managing and analyzing prescribed infusion programs. In this system, patient and IV container information is provided in machine readable format. This information is read by a bar code reader attached to the pump. The pump has a processor that is programmed to compare the patient information to the IV container information. This system requires, therefore, that each pump be programmed (or reprogrammed) to compare the patient data to medication data. Also, if an allergy check is desired, the pump must also be programmed with a patient's allergies. Other encumbrances to such a system stem from the requirement that the pump must be able to read the patient code and the IV container code. Because pumps are mobilized frequently, disconnecting them from power and wired data communication, as well as programming the pumps with prescription data and verifying the prescription data in a mobile environment is important. The physical location of the patient code (which is usually attached to the patient) and IV container code in relation to the pump is an important, and potentially limiting, consideration. Also, changes made to data formats, such as from 1-dimensional bar code to 2-dimensional bar code, must be reprogrammed into each pump, as well as patient allergies and any other data that is or may be desirable for administering patient therapy. Further, the system of the '506 patent does not provide for an ancillary check on the pump programming data and operational instructions. Information is input into the pump without any prior check for accuracy or completeness and there is no separate system in place for reviewing programmed and operational information to ensure that it is not inaccurate, imprecise, and/or improper.
Accordingly, a need remains for a system that provides a check on patient and pump data prior to pump programming, automatically transmits checked infusion data to the pump, is easily configurable, reconfigurable, and mobile in application, and can verify and check that data programmed into the pump and pump operational data remain correct and unchanged.
The present invention is provided to solve these and other problems.